Individual provider Active NPI

Walther R Evenhuis, M. D.

  • Cardiovascular Disease Physician
  • Macon, GA
National Provider Identifier
1669524575
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
111139 Issued in GA
Practice address
3330 Northside Dr Ste 200
Macon, GA 31210-2574
Phone
(478) 309-1809
Fax
(478) 272-3589
NPI assigned
Jan 18, 2007
Last updated
May 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 111139 GA Primary

Addresses

Primary practice location

3330 Northside Dr Ste 200
Macon, GA 31210-2574

Mailing address

3330 Northside Dr Ste 200
Macon, GA 31210-2574
Phone (478) 309-1809

Other practice location 1

206 Hospital Dr Ste A
Dublin, GA 31021-2560
Phone (478) 272-3525

Other identifiers 2

IdentifierTypeStateIssuer
260221100MedicaidFL
003346849BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260521000597 GA Practitioner - Cardiovascular Disease (Cardiology) 1658465372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Cardiology Associates PCGroup PAC ID 7810985645, 8 clinicians

Practice addresses (Care Compare)

3330 Northside Dr
Suite 200
Macon, GA 31210-2574
Phone (478) 272-3525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
111139GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Cardiology Associates PC CurrentSince Apr 11, 2026 Accepting new patients

Locations

206 Hospital Dr
Ste A
Dublin, GA 31021
Phone (478) 272-3525

3330 Northside Dr
Ste 200
Macon, GA 31210
Phone (478) 272-3525

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1669524575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 NORTHSIDE DR STE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102574",
            "telephone_number": "478-309-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 NORTHSIDE DR STE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102574",
            "telephone_number": "478-309-1809",
            "fax_number": "478-272-3589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 Hospital Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "GA",
            "postal_code": "310212560",
            "country_code": "US",
            "telephone_number": "478-272-3525",
            "fax_number": "478-272-3589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVENHUIS",
        "first_name": "WALTHER",
        "middle_name": "R",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "111139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260221100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003346849B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.